Lower back psychosomatics

What psychosomatics says

In psychosomatics, the lower back is support. The whole body rests on it, and it’s linked to the feeling “I’m coping” or “I can’t keep this up anymore.” When the load is too heavy and there’s no one to lean on, your back starts to hurt.

Often behind it is the feeling that you’re not good enough. Your mother-in-law doubts you’re a good mother. At work they make it clear you can’t handle it. A man left, and you decided it was your fault. Things like this hit the very foundation, who you are.

Sometimes the back starts hurting right after a hard conversation or an unpleasant thought. Try to remember what happened just before the pain appeared. Psychosomatics helps you see what load you’re carrying alone, and whose words are still telling you that you won’t cope.

What it is

Doctors call the area between the lowest ribs and the folds of the buttocks the lower back. Pain there usually comes from the muscles, ligaments, spinal joints and the discs between the vertebrae, and often no single exact cause can be found. This is called nonspecific pain. According to the Russian Ministry of Health clinical guidelines (2023), it accounts for 90–95% of cases of acute lower back pain.

According to the World Health Organization (2023), 619 million people worldwide had lower back pain in 2020. It’s the leading cause of disability on the planet. Women have it more often than men.

Pain is considered acute for up to 4 weeks, and chronic if it lasts 12 weeks or longer. According to the clinical protocol of the Ministry of Health of Kazakhstan (2025), acute pain usually goes away in 2–3 weeks, and it’s better not to stay in bed for long. According to the Russian Ministry of Health guidelines, in 90% of cases it goes away within 6 weeks, but in one person out of three it comes back within a year.

If the pain spreads to the buttock and down the back of the leg to the foot, with tingling and numbness, it’s sciatica: the sciatic nerve is irritated. Its most common cause is a herniated disc, when the soft cushion between the vertebrae bulges out and presses on the nerve. During pregnancy the ligaments soften to get ready for birth, the load on the lower back and pelvis grows, and the back can hurt too. That’s how the UK’s National Health Service (NHS) describes it.

How it shows up

• An aching lower back that gets worse when you move, walk or hold an awkward position
• The pain eases when you rest
• It’s hard to straighten up after bending, lifting something heavy or sitting for a long time
• The pain spreads to the buttock and down the back of the leg
• Tingling, burning or numbness in the leg and foot

A general practitioner or neurologist examines you. For ordinary acute pain without warning signs, scans usually aren’t needed: the protocol of the Ministry of Health of Kazakhstan advises against them in the first 4 weeks for people aged 18 to 50.